Wanetta King, LCSW
Individual provider Active NPI Military Health Care Provider · Beale Afb, CA
NPI 1366494924 · NPPES record last updated Feb 21, 2008
Key facts
- NPI
- 1366494924
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Military Health Care Provider 171000000X
- License
- 2552-C (NV)
- Practice address
- 15301 Warren Shingle Rd
Beale Afb, CA 95903-1907 - Phone
- (530) 634-3423
- Fax
- (530) 634-0670
- NPI assigned
- May 16, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2552-C | NV | MD | Military Health Care Provider |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | 2552-C | NV | Yes |
Addresses
Primary practice location
15301 Warren Shingle Rd
Beale Afb, CA 95903-1907
Mailing address
15301 Warren Shingle Rd
Beale Afb, CA 95903-1907
Phone (530) 634-3423
Other providers in Beale Afb, CA
- Alexander Dominic Jobrack
- Melissa G Johnson
- Leonid M. Katkovsky
- Shalaleh Khoei
- Jaehong Kim
- David Scott Klajic
- Patricia Ann Knepshield
- Nicolas Lara
- Allysyn Lasch-Vujevic
- Michelle Lynn Laughlin
All providers in Beale Afb, CA · Military Health Care Provider in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.